Arch Surg 1995 Feb;130(2):153-6

Orthotopic liver transplantation for benign hepatic neoplasms

Tepetes K, Selby R, Webb M, Madariaga JR, Iwatsuki S, Starzl TE
Department of Surgery, University of Pittsburgh, Pa.

Abstract
OBJECTIVE: To evaluate the frequency and outcome of liver transplantation for
symptomatic, unresectable, benign hepatic neoplasms. DESIGN: Retrospective
study. SETTING: Presbyterian University Hospital, a tertiary care referral
center for liver transplantation affiliated with the University of Pittsburgh
(Pa). PATIENTS: All 3239 liver transplant recipients at the University of
Pittsburgh from January 1981 until January 1993. RESULTS: Twelve (0.37%) of 3239
patients required liver transplantation for benign, highly symptomatic hepatic
neoplasms that were unresectable. Origins included adenoma (n = 6), mesenchymal
hamartoma (n = 2), massive hepatic lymphangiomatosis (n = 1), hilar fibrous
angiodysplasia (n = 1), focal nodular hyperplasia (n = 1), and hemangioma (n =
1). There were three perioperative deaths and two late deaths at 56 and 84
months. The remaining patients are alive, with follow-up ranging from 36 to 145
months. Median survival for the nine patients who survived the perioperative
period is 88 months. The early deaths were attributable to hemorrhagic
complications (n = 2) and necrotizing pancreatitis (n = 1). The two late deaths
were due to disseminated aspergillosis and hepatitis-associated cirrhosis.
CONCLUSION: Patients with severe symptoms from benign hepatic neoplasms that are
not resectable can be treated by total hepatectomy and orthotopic liver
transplantation, with the expectation of good long-term results